Description:

The 3HP regimen is a short-course tuberculosis preventive treatment (TPT) regimen comprising isoniazid and rifapentine, used to treat latent tuberculosis infection (LTBI) and reduce the risk of progression to active tuberculosis (TB). In patients with rheumatological diseases, particularly those receiving biologic or targeted synthetic disease-modifying antirheumatic drugs (DMARDs) and other immunosuppressive therapies, tuberculosis screening and appropriate preventive treatment are important to mitigate the risk of tuberculosis reactivation.

The conventional 3HP regimen consists of once-weekly isoniazid and rifapentine for 12 weeks. Clinical trials in high-risk rheumatic diseases have demonstrated that three months of weekly rifapentine and isoniazid regimen was non-inferior to nine months of daily isoniazid for TB prevention with lower incidence of hepatotoxicity. It also offers higher treatment completion rates and better patient adherence due to its shorter duration of treatment.

Available evidence also suggests that 3HP is generally well tolerated in patients with rheumatic diseases, with acceptable safety profile and low rates of serious adverse events.